Mr Larry Michael Wiedenhoft, EMT - Emergency Medicine in Manzanita, OR

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Mr Larry Michael Wiedenhoft, EMT is a Emergency Medicine - Emergency Medical Services physician based in Manzanita, Oregon. Mr Larry Michael Wiedenhoft is licensed to practice in Oregon (license number 143317) and his current practice location is 465 Manzanita Ave, Manzanita, Oregon. He can be reached at his office (for appointments etc.) via phone at (503) 704-1006.

NPI number for Mr Larry Michael Wiedenhoft is 1972139418 and his current mailing address is Po Box 810, Manzanita, Oregon. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1972139418.

Contact Information

Mr Larry Michael Wiedenhoft, EMT
465 Manzanita Ave,
Manzanita, OR 97130-0810
(503) 704-1006
Not Available

Map and Direction




Physician's Profile

Full NameMr Larry Michael Wiedenhoft
GenderMale
SpecialityEmergency Medicine - Emergency Medical Services
Location465 Manzanita Ave, Manzanita, Oregon
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1972139418
  • Provider Enumeration Date: 03/17/2020
  • Last Update Date: 03/17/2020

Medical Identifiers

Medical identifiers for Mr Larry Michael Wiedenhoft such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1972139418NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207PE0004XEmergency Medicine - Emergency Medical Services 143317 (Oregon)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Larry Michael Wiedenhoft is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Larry Michael Wiedenhoft, EMT
Po Box 810,
Manzanita, OR 97130-0810

Ph: (503) 704-1006		Mr Larry Michael Wiedenhoft, EMT
465 Manzanita Ave,
Manzanita, OR 97130-0810

Ph: (503) 704-1006

Reviews and Comments


Emergency Medicine Doctors in Manzanita, OR


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